As a PG aspirant, I used to ask my seniors if there was some easy way to read Harrison’s medicine textbook and what to read in it. I was usually recommended to read it as a whole. During that time all my attempts were to do the same, but at the end, I recognised we could also have the same results in approaching the text in a different way, by knowing what to read, knowing what topics to concentrate on really helps you to master the key points before the exam. Not only that it is much easier to revise every time before the exam too. So at this point, I would like to share the way that I tackled the mammoth book "Harrison’s Principles of Internal Medicine"
My methodology of taming the mammoth book was to mark the important points , as you read it for the first time.I used fluorescent markers to highlight the most important points. My time management strategy was take max of 3 days to go through a system for the first read. for eg- resp or renal system can be covered in 2 days.Once I got the imp points marked,it was easy to revise the systems.Just read the highlighted /colored lines or topic, taking just one day or in rare cases 2 days max to finish a single organ system.
some times if i find any points extra,i used to stick on yellow stick-on paper to stick and jot down extra points on it.......
my recommended regions / high yield topics in harrison are
[PS- As you read the high yield areas, it is better if you have your text with you and skip through, it will help you to get the maximum out of this article]
1.chapter 3- principles of clinical Pharmacology - a gold mine for Pharmacology facts, which takes care of most of general pharmacology questions-a must read before any exam
2.chapter 4- topic about screening .A fast revision through it gives a good idea about the screening methods.Even last year it was asked about which ca screening was most cost effective. And questions like that could only be tackled if you read the topic
3.chapter 11- chapter on pain mechanisms-more and more questions from here in subjects like pharmacology and physiology.
4. chapter 11 to 39-chapters on symptomatology from.Here chapter 14 -on headache is a must read. The rest clinical topics can be skipped if you remember your clinics even moderately.
5.chapter 46- the chapter on Dermatology,very helpful for skin mcqs esp. for exams like PGIMER. Definitely have a brush thru the chapter but skippable if time does not permit.
6.chapter 52,53,54,55,90 to 100,101 to 103-chapters on hematology- one of the best text written about the topic. Be on a look out for new drugs here.a must read topic for all pg exams.takes care of Physiology , Pathology and Pharmacology in haematology
7.chapters on genetics-chapter 56,57,58- I found Robbins more helpful in mastering the topic .but please go thru the tables as they are high yield areas.
8.chapter 59- indications of stem cell therapy.
9.chapter 64-obesity-drugs, treatment, Pathology
10.chapter 66-89- chapters on oncology - this is a very high yield area.Every year, more and more questions are appearing from tumours.I finished the whole section in 3-4 intermittent days,a fast brush through marking the points.No need to take longer time than that.
11. part six- chapters 104 to 118- chapters on organ infections like infective endocarditis, osteomyelitis will help answer MCQs in different specialities like orthopaedics, SPM, surgery etc.. a high yield area for every exam
12. from 119 to204- is a very big section on various pathogens. my approach was,while I did Mudit Khanna or Ashish gupta I back referred to brush through the corresponding pathogens[which of course are the most important ones] .that helped a lot .Don’t forget to read the most common pathogens first , then as a second round focus on the less heard ones. I also did a second sitting with a pal of mine, to conquer all that monotonous data with lot of memorising to do.You can make the most out of it if some one else reads Microbiology text with you and add points like culture mediums, appearances of colonies, diagnostic tests or techniques. In that way,master each infection at a time .
13.chapter 118-gives a full coverage on antimicrobial drugs-a very good text.You can revise the whole antimicrobial drugs in an hour.
14.chapters 208 to 232 is about cardiovascular system. I personally felt it to be very time consuming and less cost effective.so I did a selective reading rather than cover the big whole topic as a whole.Back reference of important points chapters on heart failure, valvular disease cong diseases , CAD etc as you go through your guides.
15. chapters 233-248 -chapters on respiratory system.this is one of the sections where reading it completely is worth a lot. Definitely a must read.
16.chapers 259 to 270- chapters on renal system- another cost effective read. can cover the whole topic in a day ,all except the topic renal failure.the topic of renal failure can be done in another day or half.
17. chapter 271-281-chapters on GIT.Most portions here are covered in surgery but still a lot of MCQs here.So do a fast read,can be finished in less than a day.Also highlight important drugs and points .
18.chapters 282-294 - chapters on liver and biliary and pancreas. You can do first read in 2 days.Stress on topics like hepatitis,transplant etc
19. chapters 295-297- chapters on immune system basics.Not that a high yield read ,but do back referring especially the tables.Read immune deficiency diseases.I personally prefer Robbins better for covering the topic.
20. chapters 298 to 310, contains a lot of very high yield topics.topics like amyloidosis, sarcoidosis, rheumatic fever, RA ,vasculitis syndromes like Wegner’s etc.These topics are also less forgettable areas once u read.
21. 311-316- Topics on joint disease.Not a five star area,except for selected topics like gout.so it is better if you do only back referring.don’t waste a whole day here just to cover the whole topic. the rest of topics are skippable if time doesnt permit.
22.chapters on endocrinology-chapters 317 to 330- lot of MCQs scattered here.but considering size,its better if you back refer as needed rather than try to digest it as a whole. especially high yield are thyroid, pituitary,adrenals etc-the new highlighted amiodarone induced thyroid disease . also read the basic Physiology of each endocrine gland too.Helps a lot. But if u really have time or preparing for an exam far away, it's no harm in reading completely because that will help in other subjects like Paediatrics , Pharmacology , Gynaecology and even some surgery.
23. chapter 331-334-only do back referring - focus on five star topics like parathyroid and osteoporosis
24.chapters 335-344- not a five star topic if u r good in Biochemistry.you can skip these regions if your preparation is for a short term exam.
25. chapters 345-362- chapters on neurology. only bother to read completely,if you are a die hard NIMHANS aspirant.For the rest,just focus on high yield chapters like seizure treatment, CVA, Alzheimer’s, ms, infections, prion diseases and only back refer and mark the important points. saves lot of time!with almost same effect for usual PG exams.
26.chapters 363-369-chapters on muscle and nerve disease- must read topics are GBS, muscle dystrophies and myositis
27.chapters 370-375- Chapters on mental illness.better given in Psychiatry text.
28.chapters 376 to 379- the topic on poisons and overdose is very important and the rest is skippable
Apart from the above mentioned.. make sure u glance thru "every table in harrison and Robbins" - especially PGI aspirants. they give a summary like picture of the whole text and are very high yield also.
And that, dear people sums a review of the whole of harrison , chapter by chapter........
Remember ,the whole idea/principle behind your study should be to place data in such a way,that they can be revised fast before each exam.
when revising harrison,go through the book system wise. revision of each organ system may take about a day.so u can finish the important organ sytems and points in whole of harrison in a week.and it will definitely boost up your confidence and approach to the exam.
ps- a word of advice- please make sure that u master the most asked areas first then go to the less important ones.. because it is the former that may save you... and the latter help you to top above it.. but u need a strong base before u go for the top.........
Dont be mislead;because medicine alone is not sufficient for you to get through pg exams.even though Harrison is "the holiest of all the books". make sure u master the small topics like SARP, ENT , Ophthalmology , Forensic . it really makes a difference and helps you top over the crowd.
I hope this was a help for all pg aspirants. All the best for your preparations...
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